title: Complete remission after neoadjuvant chemoradiation in a stage IV vulvar cancer patient.
abstract: BACKGROUND
  Surgery is the standard in the management of vulvar cancer. Several studies assessed the feasibility of radiochemotherapy as definitive therapy and/or neoadjuvant procedure in order to limit the extent of surgery. Combined radiochemotherapy is associated with considerable toxicity. The authors report on a modified neoadjuvant radiochemotherapy schedule which is isoeffective to the GOG (Gynecologic Oncology Group) protocol, but associated with less therapy-related toxicity.
  
  
  METHODS
  A 36-year-old woman with stage IV vulvar cancer and long-distance rectal infiltration is reported. Laparoscopic pretherapeutic staging confirmed pelvic and paraaortic lymph node metastases.
  
  
  RESULTS
  The patient received a neoadjuvant radiochemotherapy. After complete remission, a simple vulvectomy carried out 3 months later showed no evidence of tumor. Up to now, there is no evidence of tumor progression or recurrence.
  
  
  CONCLUSIONS
  Preoperative conventionally fractionated simultaneous radiochemotherapy seems to be a feasible and safe treatment option for patients with locally advanced vulvar cancer in order to avoid exenterative surgery.
authors.affiliation: Department of Radiooncology, Charité University Hospital, Berlin, Germany.
authors.forename: Annett
authors.initials: A
authors.lastname: Bischoff
authors.forename: Simone
authors.initials: S
authors.lastname: Marnitz
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
authors.forename: Roberto
authors.initials: R
authors.lastname: Kurzeja
authors.forename: Lars
authors.initials: L
authors.lastname: Morawietz
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Volker
authors.initials: V
authors.lastname: Budach
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001913:Bowen's Disease / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D030361:Papillomavirus Infections / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology; D012007:Rectum / Q000473:pathology / Q000528:radiation effects; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D014844:Vulva / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery